Introduction to HIV Surveillance System

The earliest documented case of Human Immunodeficiency Virus (HIV) infection dates back to 1959. Clinically, Acquired Immunodeficiency Disease Syndrome (AIDS) was first observed in 1981 in the United States. HIV was identified as the cause of AIDS in 1983 by research groups led by Dr. Luc Montagnier at the Pasteur Institute, Paris and Dr. Anthony Gallo of the National Cancer Institute, Washington.

Globally 36.7 million people are living with HIV and 1.1 million people died of AIDS related illnesses in 2015. World Health Organisation (WHO) proposed the introduction of HIV Sentinel Surveillance (HSS) system to monitor the extent and trends of the HIV epidemic. To better understand the course of the epidemic and its relationship to changes in the behaviours that spread it, United Nations for AIDS and WHO proposed the use of second generation surveillance tools. This aims to integrate the biological as well as the behavioural information.

HIV was first detected in India in 1986. As per the 2015 India HIV estimation, 21 lakh people are living with HIV and 67 thousand deaths occurred due to AIDS related causes in 2015. HIV Surveillance was initiated in 1985 by Indian Council of Medical Research (ICMR). With the establishment of National AIDS Control Organisation (NACO) in 1992 HSS was initiated in 1993-94 which was then formalized as an annual activity from 1998. From 2008-09 onwards it is conducted once in two years. So far 14 rounds of HSS have been completed. The 15^th Round is in process and is expected to be completed in 2017.

India has one of the world’s largest and most robust HSS. HSS measures the prevalence of HIV in a specific risk group in a specific region at specific time point. It monitors the HIV epidemic patterns among the High Risk Groups (HRG), the Bridge Population and General Population. In 2013-2015, National Integrated Biological and Behavioural Surveillance (IBBS) was carried out among the HRG and Bridge population.

The HIV surveillance is ever changing with expansion to include new sites, collection of new information and additional biomarkers for study.